Individual
SHIRLEY JENNIFER DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6941 EASTCHASE LOOP, MONTGOMERY, AL 36117-6876
(334) 603-0066
Mailing address
2705 MANASCO LN APT 7, PRATTVILLE, AL 36066-6614
(678) 790-9730
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D006612-C1
AL
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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